Background:Colonoscopy is difficult in elderly patients and is accompanied by more frequent abdominal pain and tissue injury. Aims:To investigate the impact of water infusion colonoscopy on abdominal pain and inflammatory response in elderly patients. Methods:Forty elderly patients requiring colonoscopy were enrolled from Jan. 2014 to Jun. 2016 at the Nanyang Second People’s Hospital and randomly allocated into two groups:colonoscopy with traditional air insufflation and colonoscopy with water infusion instead of air insufflation for cecal intubation. Times of cecal intubation and withdrawal were recorded;visual analogue scale( VAS)was used to assess the severity of abdominal pain;and serum levels of three inflammatory indices,tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and C-reactive protein(CRP)were determined by ELISA before and after the procedure. Results:VAS score at colonoscopy in water infusion group was significantly lower than that in air insufflation group(P﹤0. 05),however,times of cecal intubation and withdrawal were not significantly different between the two groups(P﹥0. 05). Before the procedure,serum levels of inflammatory indices were similar between air insufflation group and water infusion group(P﹥0. 05);0,6 and 24 hours after the procedure, serum levels of TNF-α,IL-6 and CRP in air insufflation group were significantly increased(P﹤0. 05)and higher than those in water infusion group at the same time points(P﹤0. 05). These inflammatory indices were recovered more rapidly in water infusion group than in air insufflation group. Conclusions:For elderly patients,colonoscopy with water infusion might ameliorate abdominal pain and inhibit systemic inflammatory response effectively.

Objective To compare the effects of different administration routes and dosages of tropisetron on cisplatin-induced kaolin intake in rats.Methods Ninety-six healthy adult male Wistar SPF rats were randomly divided into 8 groups(n =12 each):intrathecal (IT) control group (group TC) and 3 tropisetron groups receiving IT tropisetron 10,20 and 30 μg,the volume of each group was 30 μl (group T10,T20,T30),intravenous(Ⅳ) control group (group IC) and 3 tropisetron groups receiving Ⅳ tropisetron 0.3,0.5 and 0.7 mg/kg respectively (group I0.3,I0.5,I0.7).In group TC and IC,normal saline 30 μl and 0.5 ml were injected IT and Ⅳ,respectively.All rats received cisplatin 3mg/kg by intraperitoneal injection at the time point of thirty minutes after administration,each rat weight,the daily food and kaolin intakes were detected at the time point of 48 hours after cisplatin administration.Results Compared with group Tc,each rat weight loss,the kaolin intakes were significantly decreased (P ＜ 0.05),and food intake dose was significantly increased in group T20 (P ＜ 0.05).Compared with group IC,each rat weight loss,the kaolin intakes were significantly decreased (P ＜ 0.05),and food intake dose was significantly increased in group I0.5 and I0.7 (P ＜0.05).There was no significant difference between group I0.5,I0.7 and group T20.Conclusions The kaolin intakes and the rat weight loss can be decreased by IT tropisetron,and the food take dose was increased meanwhile,and IT tropisetron 20 μg has equivalent efficacy to IV tropisetron 0.5 or 0.7 mg/kg.IT could be the new administration route of tropisetron.

Objective To investigate the clinical distribution situation and drug resistance change of Klebsiella pneumoniae in the Navy General Hospital during 2011‐2015 in order to provide reference for rational use of antibacterial agents in clinic .Methods The clinically isolated Klebsiella pneumoniae in this hospital during 2011‐2015 were selected and performed the analysis on the de‐tection rate ,department distribution ,specimens source ,resistance of antibacterial drugs and change trend of resistance to carbapen‐em antibacterial drugs .Results The number the detected Klebsiella pneumoniae strains and isolation rate during 2011 -2015 showed an increasing trend year by year ,the specimens sources were mainly from 10 departments of intensive care units(ICU) ,hy‐perbaric oxygen department ,respiratory department ,radiation oncology department ,kidney disease department ,etc .;the submitted specimens were dominated by sputum and urine ,accounting for 59 .7% and 21 .4% of submitted specimens ;the drug resistance of Klebsiella pneumoniae during 2011‐2015 showed the increasing trend year by year .Klebsiella pneumoniae had higher resistance rates to piperacillin ,ampicillin ,ampicillin/sulbactam and cefuroxime and had lower resistance rate to amikacin ,imipenem ,meropen‐em and tobramycin ;the resistance rates to imipenem and meropenem were increased year by year ,and pan‐drug resistant Klebsiella pneumoniae showed a rapidly rising trend .Conclusion The drug resistance of Klebsiella pneumonia is serious ,especially carbapene‐ms‐resistant Klebsiella pneumoniae is significantly increased in the recent years ,therefore its drug resistance monitoring should be strengthened for guiding rational drug use in clinic .

Objective To explore the relationships among post traumatic stress disorder(PTSD),gratitude and posttraumatic growth (PTG) for terminal cancer patients.Methods Totally 119 advanced cancer patients were investigated with the self-demographic questionnaire,posttraumatic growth inventory (PTGI),the PTSD cheeklist-civilian version (PCL-C) and the Gratitude Questionnaire-6 (GQ-6).Results For terminal cancer patients,the total score of PCL-C was 34.02±12.49.The scores on re-experience,avoidance/numbness,hypervigilance were 9.79±3.78,13.85±5.68,10.36±3.80.The total score of gratitude was 29.37±7.48.The total score of PTG was 51.34± 13.57.The scores of life appreciation,personal relationship and self-strength were 8.00± 2.99,21.18± 5.84,22.16± 6.10.The total scores of PTG were significantly statistical significance among different PTSD groups(F=16.267,P＜0.01)and gratitude groups(F=43.674,P＜0.0 1).The total scores of PCL-C (r=-0.694,P＜0.01),re-experience (r=-0.664,P＜0.01),avoidance/numbness (r=-0.671,P＜0.01),hypervigilance (r=0.753,P＜0.01) and gratitude(r=-0.611,P＜0.01) were all correlated with PTG.The total score of PCL-C and gratitude could explain 66.6％ variation of PTG.For the relationship between PTSD and PTG,the moderation effect of gratitude was not significant (P ＞0.05).Conclusion The gratitude and PTSD were important influence factors for terminal cancer patients' PTG,while the moderation effect of gratitude was not significant,so in clinical intervention we should pay more attentions to the actual effects of gratitude,and we should not pursuit gratitude education blindly.

Aim To investigate the hypoglycemic pathway of terpenes from Cornus officinalis(TCF) from three aspects of insulin dependence, α-glucosidase inhibition, insulin sensitizing.Methods Insulin-deficient diabetes mellitus(DM) model was induced by tail vein injection of streptozotocin(STZ) into SD rats at the dose of 50mg·kg-1 body weight.Rats were randomly divided into seven groups: control group(CON), model group(Model), metformin group(Met) 0.1g·kg-1, shenqi jiangtang granules(Shenqi) group 1.0 g·kg-1, three dose groups of TCF: 0.10, 0.05, 0.025 g·kg-1.Body weight and blood glucose were measured every week.After four weeks, glycosylated hemoglobin (HbA1c), glycosylated serum protein (GSP) were determined.Normal ICR mice were divided into seven groups: CON, Model, Met group 0.2g·kg-1, acarbose group(Acar) 0.1 g·kg-1, Shenqi group 1.5g·kg-1, three dose groups of TCF: 0.20g·kg-1;0.10g·kg-1;0.05 g·kg-1.After 10 days of administration, intraperitoneal injections of glucose and gavage starch tolerance tests were employed.Normal SD rats were divided into six groups: CON, rosiglitazone group 0.02 g·kg-1, glipizide group 0.02 g·kg-1, three dose groups of TCF: 0.10, 0.05, 0.025 g·kg-1.After seven days of administration, intraperitoneal glucose tolerance test(IPGTT) was employed and levels of insulin was determined.Results (1)High dose of TCF significantly reduced the level of HbA1c(P<0.05), GSP(P<0.05) on STZ model rats;(2)TCF significantly improved the glucose tolerance and gavage starch tolerance in ICR mice(P<0.05);(3) High dose of TCF significantly reduced the blood glucose and serum insulin level.Conclusions TCF has obvious effects on inhibiting glucose absorb and promoting the use of glucose.It is able to exert hypoglycemic effect through non-insulin dependent pathway, whereas, whether it has the effects of α-glucosidase inhibition and insulin sensitization should be further validated.

Objective To investigate surgical exposure,reduction and fixation of the severe Pilon fractures. Methods A total of 11 patients with severe Pilon fractures (Rüedi-Allgwer type Ⅲ or AO/OT type C3 ) were managed by anteriormedial malleolar approach in combination with transfibular fracture or fibular osteotomy approach to reveal the tibiotalar joint.Reduction was performed under direct vision and then the tibia was fixed followed by fibula fixation. Results All patients obtained satisfactory bone reduction including nine patients with Ⅰ stage wound healing and two with Ⅱ stage wound healing.No sclerotin infection occurred.The fractures as well as the osteotomy sites were healed. Conclusions The double operative approaches can completely expose the tibiotalar joint,favor the reduction and fixation of the displaced bone fragments and attain satisfactory short-term reduction and fixation effects in the treatment of severe Pilon fractures.

Objective:To analyze the expression of LETM2 in KYSE150 and ECA109 cell lines and its effect on the proliferation, migra-tion, and invasion of esophageal squamous cell carcinoma (ESCC). Methods:The expression level of the LETM2 protein in 90 paired hu-man ESCC tissues and matched adjacent normal tissues was determined through immunohistochemistry. The expression level of LETM2 in ESCC cell lines was detected by real-time PCR and Western blot. The expression levels of LETM2 in KYSE150 and ECA109 cell lines were knocked down using lentivirus. MTT assays were performed to examine the effect of LETM2 on the proliferation of ESCC cells. Colony formation assay was used to detect the colony formation ability. Flow cytometry was performed to analyze the cell cycle. The effect of LETM2 depletion on the migration and invasion of ESCC cells was determined by Transwell assay. Results:LETM2 expres-sion was frequently upregulated in the ESCC tissues than in the adjacent normal tissues. The suppressed exogenous expression of LETM2 led to the inhibition of cell proliferation and colony formation. However, cell migration and invasion were not affected. The re-sults on the cell cycle distribution revealed that LETM2 knockdown acts as a negative regulator of the cell cycle at the G1 to S phase transition. Conclusion:LETM2 acts as a tumor-driven gene in the development and progression of ESCC. This finding suggests that LETM2 can be used as an efficient prognosis biomarker and a potential therapeutic target for ESCC.

ThisstudywasaimedtoobservetheinhibitoryeffectsofQi-Zhu (QZ)granulesonearlyproteinuria in diabetic nephropathy rats with syndrome of qi-yin deficiency and phlegm blocking collaterals. A total of 44 rats were randomly divided into the blank group, model group, Huang-Kui capsule group, QZ granules group. The rat model of diabetic nephropathy with syndrome of qi-yin deficiency and phlegm blocking collaterals was induced by the combination of unilateral renal artery ligation, diet of high-calorie and high cholesterol, and intraperitoneal injection of low-dose streptozotocin. The medication was given for 8 weeks. The concentrations of protein and creatinine in urine were observed on the 4th week. The blood glucose, blood lipids, liver function and renal pathological changes were observed at the end of the experiment. The results showed that compared with the model group, QZ granules can obvious suppress early proteinuria in diabetic nephropathy, promote creatinine excretion, regulate blood lipid metabolism, protect liver function and improve renal pathological changes. It was concluded that QZ granules had independent inhibition effect on early proteinuria in diabetic nephropathy rats with syndrome of qi-yin deficiency and phlegm blocking collaterals. The effect was independent of lowing blood glucose. It represented the corresponding relation between the syndrome and efficacy in Chinese herb compounds.

The S1 protein of the infectious bronchitis virus (IBV) is a major structural protein that induces the production of the virus-neutralization antibodies. The monoclonal antibody against the IBV M41 S1 protein was used as a target for biopanning. After three rounds of biopanning, randomly selected phages bound to the monoclonal antibody. Sequence analysis showed that the dominant sequence was SFYDFEMQGFFI. Indirect competitive enzymelinked immunosorbent assay showed that SFYDFEMQGFFI is a mimotope of the S1 protein that was predicted by PepSurf. The mimotope may provide information for further structural and functional analyses of the S1 protein.

The S1 protein of the infectious bronchitis virus (IBV) is a major structural protein that induces the production of the virus-neutralization antibodies. The monoclonal antibody against the IBV M41 S1 protein was used as a target for biopanning. After three rounds of biopanning, randomly selected phages bound to the monoclonal antibody. Sequence analysis showed that the dominant sequence was SFYDFEMQGFFI. Indirect competitive enzymelinked immunosorbent assay showed that SFYDFEMQGFFI is a mimotope of the S1 protein that was predicted by PepSurf. The mimotope may provide information for further structural and functional analyses of the S1 protein.